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It is important to discuss your beliefs and wishes with your health care surrogate. When instructing your health care surrogates about your wishes in the event you become incapacitated and they need to make health care decisions, you should consider the following questions. There are no right or wrong or “preferable” answers to these questions. Each person should answer these questions based on his or her own beliefs and convey those beliefs and wishes to their health care agents. Any other wishes or desires that you feel your health care agents should know should also be given to them so that they can carry out their responsibilities as you would wish.

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  • Do you think you would want to have any of the following medical treatments performed on you?
    a. Kidney dialysis;
    b. Cardiopulmonary resuscitation, also called CPR (used if your heart stops beating);
    c. Respirator (used if you are unable to breathe on your own);
    d. Artificial nutrition (used if you are unable to eat food);
    e. Artificial hydration (used if you are unable to drink fluids)
  • Do you want to donate parts of your body to someone else at the time of your death? (This is called “organ donation”).
    of your death? (This is called “organ donation”).
  • If you have current medical problems, in what ways, if any, do they affect your ability to function?
  • If you have a doctor, do you like him or her? Why?
  • Do you think your doctor should make the final decision regarding your needs?
  • How important is independence and self-sufficiency in your life?
  • If your physical and mental abilities were decreased, how would that affect your attitude toward independence and self-sufficiency?